An update on drug resistance: CDC Antibiotic Threat Report 2019

Kalvin Yu, M.D., Medical Director, Medical Informatics, BD

Nov 20, 2019


On November 13, 2019, the Centers for Disease Control (CDC) updated their Antibiotic Resistance Threats Report, highlighting drug-resistant bacteria and other pathogens that pose a threat to public health. 1 By quantifying the potential risk of mortality and other indicators of poor outcomes, this report helps clinicians, academicians and related industry focus on the threat of antimicrobial resistance (AMR). The CDC collaborated with various industry and research-related groups to conduct their analysis. BD participated by contributing a considerable increase in the CDC’s total coverage across the nation, and by sharing methodologic insights from our own recent publications on trends of drug resistance and antimicrobial use. 2,3,4

The updated Threat Report confirms that drug resistance is a significant public health issue. 1 Of particular note, the CDC has stated that this revised version has helped in gaining insight to the possibility that the previous report likely underestimated the prevalence and mortality associated with drug-resistant pathogens. While the patterns of some multi-drug-resistant pathogens have plateaued, others like Extended-Spectrum Beta-Lactamase-producing E. coli (ESBL-EC) continue to increase, particularly in the outpatient community setting. The CDC has also identified new organisms such as Candida auris, which tends to be inherently resistant to the most commonly used antifungal drugs, and known bacteria like Clostridiodes difficile that are highlighted due to their increasingly detrimental clinical impact. 1

The federal government has made a commitment to mitigate resistant pathogens and practices such as antimicrobial misuse that may contribute to the problem, and industry collaborators such as BD are aligned with their objectives. Technologies that tether infection prevention and antimicrobial stewardship programs in hospital surveillance can be designed to support the new Center for Medicare and Medicaid Services (CMS) Conditions of Participation, which require hospitals to implement infection prevention and antimicrobial stewardship programs (effective March 30, 2020). 5 Innovations in diagnostics, infection prevention and antimicrobial stewardship have the potential to provide insights involving invasive devices or analytics to help report and mitigate hospital acquired infections.

As the Threat Report gains traction among clinicians and public health agencies worldwide as a benchmark in the fight against antimicrobial resistance, industry can continue to be a valuable partner. Our contribution to this report—and that of others from industry—is an example of how a national estimate is optimized when combining the individual pieces of patient care that we provide together. The insights from the updated Threat Report are exemplary of what industry can contribute while working together to characterize the changing landscape of AMR.

Learn more

Each month on the BD Institute for Medication Management Excellence blog, thought leaders explore topics of critical importance to medication management, and provide additional ways to learn.

Now that you've read about the CDC’s Threat Report, deepen your understanding of antimicrobial stewardship programs and their potential to impact infectious disease outcomes. Then explore the burden of drug shortages on clinical care and the challenges of patient-specific medication management.


References
  1. U.S. Department of Health and Human Services: Centers for Disease Control and Prevention. Antibiotic Resistant Threats In The United States; 2019. https://www.cdc.gov/drugresistance/biggest-threats.html
  2. Tabak Y, Srinivasan A, Yu K et al. Hospital-level high-risk antibiotic use in relation to hospital-associated Clostridioides difficile infections: Retrospective analysis of 2016–2017 data from US hospitals. Infection Control & Hospital Epidemiology. 2019;40(11):1229-1235. doi:10.1017/ice.2019.236
  3. Gupta V, Ye G, Olesky M, Lawrence K, Murray J, Yu K. National prevalence estimates for resistant Enterobacteriaceae and Acinetobacter species in hospitalized patients in the United States. International Journal of Infectious Diseases. 2019;85:203-211. doi:10.1016/j.ijid.2019.06.017
  4. Gupta V, Ye G, Olesky M, Lawrence K, Murray J, Yu K. Trends in resistant Enterobacteriaceae and Acinetobacter species in hospitalized patients in the United States: 2013–2017. BMC Infect Dis. 2019;19(1). doi:10.1186/s12879-019-4387-3
  5. Dall C. New rule requires antibiotic stewardship programs in US hospitals. CIDRAP.umn.edu. http://www.cidrap.umn.edu/news-perspective/2019/09/new-rule-requires-antibiotic-stewardship-programs-us-hospitals. Published 2019. Accessed November 14, 2019.

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